prompt1 : extract information from  breast pathology report. List the histological classification, i.e. type of cancer or DCIS, subtype, description of any necrosis, any mention of tumor infiltrating lymphocytes,  histological grade, nuclear grade,  lymphovascular invasion, calcification, receptor status, IHC and any other ancillary testing results.  List out and expand the main points.
prompt2 : The report is - Subtype LumB, Female. Admission Date: Discharge Date: Pathology Addendum Report. Collected Date/Time: Received Date/Time: Addendum Report. ASSAY PERFORMED: HER2 GENE AMPLIFICATION BY DUAL IN SITU HYBRIDIZATION USING THE. HER2 Dual ISH DNA PROBE COCKTAIL. Number of nuclei scored: 20. Total HER2 signals: 60. Total CHR 17 signals: 39. HER2/CHR 17 ratio: 1.5. INTERPRETATION: - NEGATIVE FOR HER2 GENE AMPLIFICATION. NOTE: THE ASSAY WAS PERFORMED AS A REFLEX TEST AFTER THE HER2/NEU IMMUNOSTAIN WAS 2+. SPECIMEN TYPE: The. HER2. is performed on a formalin-fixed paraffin-embedded tissue slide from. block C3. DESCRIPTION OF THE ASSAY: The. HER2. assay. enables the HER2. gene and Chr17 centromere to be co-hybridized and visualized via light microscopy on the same slide. Specifically for this assay,. HER2 is detected by a dinitrophenyl (DNP) labeled probe visualized utilizing. SISH DNP (silver in situ hybridization). detection kit. The Chr17 centromere is targeted with a digoxigenin (DIG) labeled probe and detected using. ISHDIG. detection kit. Dual ISH staining results in visualization by light microscopy and which HER2 appears as discrete black signals (SISH). and Chr17 as red signals in nuclei of normal cells serving as internal positive control for staining) as well as in carcinoma cells. SLIDE SCORING: Once an adequate target area is identified the reader records the scores for HER2 and Chr17 copy numbers that. are present in 20 representative nuclei. If the resulting HER2 / Chr17 ratio falls within 1.8-2.2 (EQUIVOCAL) the reader is. recommended to score an additional 20 nuclei and the resulting ratio is calculated from the total 40 nuclei. HER2 gene status is. reported as non-amplified (HER2/ Chr17 < 2.0) or amplified (HER2/Chr17> 2.0). Print Date/Time: Distribute to: Patient Locations: Pathology Addendum Report. Collected Date/Time: Received Date/Time: T. f this assay were determined by. is assay has been approved by the U.S. Food and Drug Administration This laboratory is certified under the. Laboratory Improvement Amendments of 1988 (CLIA-88) as qualified to perform high-complexity clinical laboratory testing. cpt: 88368 x2. (Electronic signature). Verified: Collected Date/Time: Received Date/Time: Addendum Report. IMMUNOHUSTOCHEMICAL EVALUATION OF ESTROGEN RECEPTORS, PROGESTERONE RECEPTORS, AND. HER-2NEU IN INVASIVE MAMMARY CARCINOMA. ESTROGEN RECEPTORS: 99 %, positive. PROGESTERONE RECEPTORS: 40 %, positive. STAINING INTENSITY: moderate. HER-2NEU: SCORE 2+, EQUIVOCAL. Immunohistochemical studies were performed on formalin fixed paraffin embedded tissue (Block C3) using the following monoclonal. antibodies: Estrogen receptor (Clone SP1), Progesterone receptor (Clone 1E2) and Her-2neu. Clone 4B5); control sections. for HER-2Neu are provided within a kit (score 0 MCF-7, score 1+ T-47D, score 2+ MDA-MB-453, score 3+ BT-474). Detection. system used: polymer. Primary antibodies, reagents and control sections for HER-2neu are all provided by). All controls show appropriate reactivity. Reactivity of Estrogen and Progesterone receptors is determined based on the percentage of positively stained nuclei of tumor. cells. Reference values (CAP accreditation program checklist 2010 and guidelines on webpage): Positive: nuclear staining in 1% or greater than 1% of invasive carcinoma cells. Negative : nuclear staining in less than 1% of invasive carcinoma cells. Staining intensity: is reported as weak, moderate or strong. HER-2neu reactivity is reported applying the CAP scoring guidelines (CAP accreditation program checklist 2010 and guidelines. on. webpage): Score 0 = Negative: No immunoreactivity, or faint weak immunoreactivity in <10% of tumor cells but only a portion of the. membrane is positive.. Score 1 = Negative: Faint weak immunoreactivity in 10% or > 10% of tumor cells but only a portion of the membrane is positive. Score 2+ = Equivocal: Weak to moderate complete membrane immunoreactivity in >10% of tumor cells or. Print Date/Time. Pathology Addendum Report. Collected Date/Time: Received Date/Time: circumferential intense membrane staining in <30% of cells. Score 3+ = Positive: More than 30% of the tumor cells must show circumferential intense and uniform membrane staining. A. homogeneous (chicken wire) pattern should be present. Equivocal results for HER-2neu (Score 2+) will be subsequently followed by a reflex dual-color ISH testing. The performance characterietice of theee antihnding were determined by the. ey have not been cleared or approved by the U.S. Food and Drug Administration The FDA has determined that such. clearance or approval is not necessary. These tests are used for clinical purposes. They should not be regarded as investigational or for research. This laboratory is. certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA-88) as qualified to perform high-complexity clinical laboratory testing. (Electronic signature). Verified. Collected Date/Time: Received Date/Time: Final Diagnosis. A. RIGHT BREAST, CORE BIOPSY: - INVASIVE DUCTAL CARCINOMA. B. RIGHT SENTINEL LYMPH NODE, BIOPSY: - NO EVIDENCE OF CARCINOMA IN ONE LYMPH NODE. - SEE SPECIAL STAINS SECTION. C. RIGHT BREAST, TOTAL MASTECTOMY: INVASIVE DUCTAL CARCINOMA GRADE 2, 2.5 CM. - MARGINS OF RESECTION ARE FREE OF CARCINOMA. - SEE SYNOPTIC REPORT, SPECIAL STAINS SECTIONS AND NOTE. NOTE: hormonal receptors and Her2-neu status will be reported in an addendum. (Electronic signature). Verified: Synoptic Report. SPECIMEN: Total breast (including nipple and skin). PROCEDURE: Total mastectomy (including nipple and skin). Print Date/Time. Collected Date/Time: Received Date/Time: LYMPH NODE SAMPLING: Sentinel lymph node(s). SPECIMEN INTEGRITY: Single intact specimen (margins can be evaluated). SPECIMEN SIZE: Greatest dimension: 26 cm. Additional dimensions: 17 x 6 cm. SPECIMEN LATERALITY: Right. TUMOR SITE: INVASIVE CARCINOMA: Upper outer quadrant. TUMOR SIZE: SIZE OF LARGEST INVASIVE CARCINOMA: Greatest dimension of largest focus of invasion over 0.1 cm: 2.5 cm. Additional dimensions: 2.0 x 2,0 cm. TUMOR FOCALITY: Single focus of invasive carcinoma. MACROSCOPIC AND MICROSCOPIC EXTENT OF TUMOR: Skin: Invasive carcinoma does not invade into the dermis or epidermis. DUCTAL CARCINOMA IN SITU (DCIS): DCIS is present. Extensive intraductal component (EIC) negative. SIZE (EXTENT) OF DCIS: Estimated size (extent) of DCIS (greatest dimension using gross and microscopic evaluation) is at least 0.3 cm (constituting. about 5% of the entire tumor mass.). ARCHITECTURAL PATTERNS: Comedo. Cribriform. NUCLEAR GRADE: Grade III (high). NECROSIS: Present, central (expansive "comedo" necrosis). LOBULAR CARCINOMA IN SITU (LCIS): Not identified. HISTOLOGIC TYPE OF INVASIVE CARCINOMA: Invasive ductal carcinoma (no special type or not otherwise specified). GLANDULAR (ACINAR)/TUBULAR DIFFERENTIATION: Score 2: 10% to 75% of tumor area forming glandular/tubular structures. NUCLEAR PLEOMORPHISM: Score 3: Vesicular nuclei, often with prominent nucleoli, exhibiting marked variation in size and shape, occasionally with very. large and bizarre forms. MITOTIC COUNT: Score 2. OVERALL GRADE: Grade 2: scores of 6 or 7. MARGINS: Margins uninvolved by invasive carcinoma. Print Date/Time: Collected Date/Time: Received Date/Time: Distance from closest margin: 25 mm. Distance from posterior margin: 25 mm. Margins uninvolved by DCIS (if present). Distance from closest margin: posterior mm. Distance from posterior margin: 25 mm. LYMPH-VASCULAR INVASION: Present. DERMAL LYMPH-VASCULAR INVASION: Not identified. LYMPH NODES: Number of sentinel lymph nodes examined: 1 (no tumor seen). Total number of lymph nodes examined (sentinel and nonsentinel): 1. METHOD OF EVALUATION OF SENTINAL LYMPH NODES: H&E, multiple levels. Immunohistochemistry. PRIMARY TUMOR (INVASIVE CARCINOMA (pT): pT2: Tumor >20 mm but less than or equal to 50 mm in greatest dimension. REGIONAL LYMPH NODES (pN): pNO: No regional lymph node metastasis identified histologically. DISTANT METASTASIS (M): Not applicable. ADDITIONAL PATHOLOGIC FINDINGS: intraductal papilloma. MICROCALCIFICATIONS: Present in DCIS. Source of Specimen. A. Core Biopsy, RT Breast. B. Lymph Nodes, Sentinel Right. C. RT Total Mastectomy. Clinical Information. Palpable mass upper central FNAB positive, patient with right breast mass. PRE-OP DIAGNOSIS: Right breast cancer. POST-OP DIAGNOSIS: Same. TYPE OF PROCEDURE: Right t mastectomy and sent to the node biopsy. Gross Description. Specimen is received in 3 parts: A. The specimen is labeled "CORE BIOPSY" and is received unfixed for frozen section diagnosis. It consists of 2 cylindrical pieces of. gray-tan soft tissue each measuring 1.5 cm in length and 0.1 cm diameter. Entirely submitted in cassette FSA 1. Time specimen was removed from the patient. Time specimen was placed in formalin. Print Date/Time: Collected Date/Time: Received Date/Time: Ischemic time: 20 minutes. B. The specimen is labeled "RIGHT SENTINEL NODE" and is received unfixed for frozen section diagnosis. (Specimen is in. formalin mother 6 hour and less than 48 hours). It consists of a ymph node measuring 1.6 x 1 x 0.5 cm. Sectioned and entirely. submitted in cassette FSB 1. Time specimen was removed from the patient: Time specimen was placed in formalin. Ischemic time: 22 minutes. C. The specimen is labeled "RIGHT TOTAL MASTECTOMY and is received in formalin. (The specimen is in the formalin. more than 6 hours and less than 48 hours). It consist of mastectomy specimen without lymph nodes weighing 990 grams and. measuring 26 x 17 x 6 cm with brown skin ellipse measuring 24 x 12 cm, containing grossly unremarkable 1.5 cm in diameter nipple. The skin is tagged with a black stitch designating lateral breast. The posterior margin is composed of smooth fascia which is inked. black. The breast is sliced in sagittal planes revealing a 2.5 x 2 x 2 cm an ill-defined firm area which is 2.5 cm away from the deep. margin of resection. The remaining portions reveal unremarkable yellow mammary fat with streaks of white-gray mammary. parenchyma. Representative sections submitted as follows: C1 = nipple. C2-C6 = upper outer quadrant mass. C7 = upper outer quadrant, posterior margin of resection in correspondence of the mass. C8 = representative section upper inner quadrant. C9 = representative section upper outer quadrant. C10 = representative section lower outer quadrant. C11 = representative section lower inner quadreant. Time specimen was removed from the patient. Time specimen was sectioned and placed in formalin. Ischemic time: 15 minutes. Intra Operative Consultation. A. Right breast cores = carcinoms. B. Right sentinel node = no tumor seen. Special Stains / Slides. Immunohistochemical studies were performed on formalin fixed, paraffin-embedded tissue (Block B1) with adequate positive and. negative control sections. Cytokeratins AE1/AE3 and Cam5.2 fail to reveal metastatic carcinoma. The nerformance characteristics of these antibodies were determined by the. ley have not been cleared or approved by the U.S. Food and Drug Administration The FDA has determined that such. clearance or approval is not necessary. 1 nese sesus are used for clinical purposes. They should not be regarded as investigational or for research. This laboratory is. certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA-88) as qualified to perform high-compiexity clinical laboratory testing. 16 H&E, 4 FS, 16 H&E. Print Date/Time. Collected Date/Time: Received Date/Time: Tissue Code. Print Date/Time:

expanded version (tokens=3425) : 
 Histological classification: Invasive ductal carcinoma
Subtype: LumB
Description of any necrosis: Central necrosis (expansive "comedo" necrosis)
Tumor infiltrating lymphocytes: Not mentioned
Histological grade: Grade 2
Nuclear grade: Grade 3 (high)
Lymphovascular invasion: Present
Calcification: Present in DCIS
Receptor status: 
- Estrogen receptors: 99%, positive
- Progesterone receptors: 40%, positive
IHC and other ancillary testing results:
- HER-2neu: Score 2+ (equivocal)
- HER2 gene amplification by dual in situ hybridization: Negative for HER2 gene amplification
- Immunohistochemical evaluation using estrogen receptor (ER) and progesterone receptor (PR) monoclonal antibodies
- Immunohistochemical evaluation of HER-2neu using the HercepTest
- Special stains: Immunohistochemical studies using cytokeratins AE1/AE3 and Cam5.2 

Main points:
- The pathology report reveals a diagnosis of invasive ductal carcinoma, subtype LumB.
- The tumor exhibits central necrosis (expansive "comedo" necrosis).
- There is evidence of lymphovascular invasion.
- The histological grade is grade 2.
- The nuclear grade is grade 3 (high).
- Calcifications are present in the ductal carcinoma in

prompt : Please generate a succinct report in 75 words from the above information. Exclude any filler words or sentences. If something is not mentioned or specified, exclude it from the report. Low verbosity.

final output (tokens=3579) : 
 Invasive ductal carcinoma, subtype LumB, with central necrosis and lymphovascular invasion. Histological grade: 2. Nuclear grade: 3 (high). Calcifications present. Receptor status: Estrogen receptor positive (99%), progesterone receptor positive (40%). HER-2neu equivocal (score 2+). Negative for HER2 gene amplification. Immunohistochemical evaluation performed for ER, PR, and HER-2neu. No metastatic carcinoma found in sentinel lymph node biopsy.

